I’m beginning to get more requests from mothers asking me to support them in their pregnancy and birth – more than I could handle, Alhamdulillah. This is a healthy sign that natural birth awareness is increasing in Singapore. I am also happy to share that more of us are getting to be certified as doulas, so InshaAllah there will always be enough supply of doulas to meet everyone’s demands.
I always encourage potential clients to go doula-shopping, i.e. interview as many doulas and find one who they can have chemistry with. It is going to be a very long relationship with someone you are going to be sharing intimate details with, so you must find someone who can really meet your needs.
If you don’t know where to start looking, you can go to the society for Doulas of Singapore webpage to look for a doula. The doulas registered under this society have gone through an interview and screening process and are able to work in Singapore hospitals. Yaqyn Birth is a member of this society.
There are also other independent doula bodies such as Fourtrimesters and Amani Birth who can also work in Singapore hospitals.
What to look for in a doula (general guidelines):
Able to meet your requirements (in terms of age, personality and background)
Able to support you with adequate information
Able to support your emotional and psychological needs
Able to meet your budget
Able to commit herself during your estimated due date
Has a back-up doula (in case of emergencies)
You feel good sharing intimate details with her
I feel that every woman should be entitled to get doula support so I hope that these links above can help you look for a suitable doula who is able to meet your needs and requirements.
If you hadn’t known yet, I am not living in Singapore at the moment. From Sept this year, to Sept next year (2012), I will be in a lovely place known as Leeds in the UK. DH is pursuing his studies at the Uni. of Leeds and brought me and DS along. 😀
Settling down had been easy, Alhamdulillah, thanks to our previous experience in Aus and NZ. This time round we’re wiser; we didn’t bring the whole house with us. I’ve made a lot of lovely friends, mostly Malaysian postgrads also from the university, and they have been very kind in helping us get the hang of things in Leeds.
Work-wise: my doula work from Singapore came with me to the UK and I’m very happy to announce that not one, not two, not three, but *four* of my mothers had a great birth experience with me as their ‘remote doula’. Watsapp is an amazing invention! Now, I had actually recommended them to get a different doula who can support them in Sg, but they reported that they had more confidence in me even though I’ll be far away. Alhamdulillah! *big smile* (I don’t recommend this though, for a guaranteed better experience, it is recommended that you get a doula in your country who can come to you and give you back massages and see you face to face, etc).
I told my mothers that “for every inch of confidence that you have in me, you must place the same amount of confidence in your birthing body and allow your baby to birth with zero or minimal medical intervention”. They listened and laboured in the comforts of their home with their DHs till the very last moments and spent just a short time in the hospital before they birthed! One first time mother was even ready to push as soon as she reached the hospital doors! SubhanaAllah, when they later told me their birth stories, I couldn’t help feeling their joy and almost feeling like I was there with them. But no, all the hard work and 100% credits go to the mother and her DH, for she had faith and confidence, and trusted her body to give birth exactly as she willed. All I did was to add that extra push of confidence to empower her. And Alhamdulillah, job done!
So you see, you *can* overcome your labour contractions at home yourself (or with DH) if you would learn to trust that Allah has designed your body for this amazing thing called childbirth. If you have had a healthy pregnancy, there is no need to panic when labour starts… you will be prepared… *breathe deep*…. and you will know how to take them in stride… *move your hips*… one contractions at a time… *visualise your baby coming down the birth canal*… and before you know it, your baby will be in your hands!
I’ve started a facebook page because I like to post links from other gentle birth sites, so please click ‘like’ and join me there. At the same time, I will also try to post updates here from time to time.
So what do you think? Can a remote doula work as effectively as a personal doula who comes to you? My honest opinion is she can’t, a ‘live’ doula can do so much more, ie: give you massages, give your DH a break, remind you to hydrate yourself, remind you to breathe, relax, loosen, to drink, to pee, etc. But if all you need is a little ‘push’ or confidence booster via watsapp, then I’ll always be here to help!
The word ‘doula’ (pronounced ‘doo-la’) is a Greek word meaning ‘woman servant or caregiver’. More recently, it refers to someone who offers emotional and physical support to a woman and her partner before, during and after childbirth. A doula (also known as a birth attendant) believes in ‘mothering the mother’, enabling a woman to have the most satisfying experience that she can, from pregnancy and into motherhood. This type of support allows the whole family to relax and enjoy the experience too.
Despite doulas being fairly unheard of in Australia, they have been actively supporting women for a very long time and are fast growing in popularity, as a result of positive word of mouth and the need for increased support. In fact looking at google statistics recently, searches on the word ‘doula’ are at its highest yet from 2004 to 2011.
Doulas are trained and experienced in childbirth and are usually mothers themselves. They have a good knowledge and awareness of female physiology, but a Doula does not support the mother in a medical role – that is the job of the midwife or doctor. She works on the basis of keeping birth normal and empowering, and should the birth become complicated and require medical assistance, a doula will still remain by your side and help in any way she can. She also does not make decisions for those she supports, but she assists them through the decision making process and provides balanced information so the couple can make their own choices.
Many women consider doulas to be a must for those giving birth in a hospital, due to the modern medicalisation of birth – unnecessary inductions are skyrocketing and 1 in 3 babies are now born by caesarean section (and yes, one of those interventions readily results in the other – its no coincidence). In Australia, some hospitals have caesarean section rates as high as 50% or more. This is a terribly high statistic, well above World Health Organisation recommendations of 10-15% – which makes us amongst the highest in the world. Given the long term emotional and physical effects this can have on the mother, her partner and baby, a doula to me is like an ‘insurance policy’ – which can help protect you from a disempowering experience. With a doula, you know that someone is always on YOUR team, holding the space for you and your family.
A doula works in birth centres, private and public hospitals and at homebirths in conjunction with midwives – but never as the sole carer at birth. Birthing without a midwife or doctor present is known as free-birthing however BellyBelly recommends birth with at a qualified midwife or doctor.
There are two types of doulas, birth doulas and post-natal doulas, with many doulas performing both roles. The difference is that the role of the post-natal doula is to nurture the mother at home after childbirth. This may include further breastfeeding support, light home duties, massage, emotional and physical support for the mother and so on. Post-natal doulas are particularly in demand as support for new mothers has reduced in modern society. Needless to say, studies show that post-natal doulas make a huge impact on the well-being of mothers.
The Promise Of A Doula
1. You cannot hurt my feelings in labour
2. I won’t lie to you in labour
3. I will do everything in my power so you do not suffer
4. I will help you to feel safe
5. I cannot speak for you; but I will make sure that you have a voice and I will make sure you are heard
What Are The Proven Benefits Of A Doula?
A recent review of many studies from around the world have concluded that a doula’s support is more effective than hospital staff, friends or family. You can read the review here.
Studies consistently demonstrate very impressive benefits for the mother, father and baby, including:
50% less caesarean sections
Reduction in the use of forceps by 40%
60% less requests for epidurals
40% reduction in the use of synthetic oxytocin for inductions or augmentations
30% reduction in use of pain medication
25% reduction in labour length
Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum
These are not misprints! The benefits are significant. Most of the women in the studies were accompanied by male partners, however study results show that women who had the support of a male partner and a doula fared best, for example, the caesarean rate of women supported by both a male partner and a doula was significantly lower (15.4%) than the caesarean rate for women supported only by their partners (24.4%). The studies also clearly show the positive benefits of doula support occur regardless of a woman’s economic status or whether or not they were privately insured. Its simply about having the right support with you at birth.
What About The Woman’s Partner – Does a Doula Replace Them?
According to the studies (and from personal observations in births I have attended) rather than reducing a partner’s participation in the birth process, a doula’s support complements and reinforces their role. Partners feel more enthusiastic and that their contribution to the labour and birth was meaningful and helpful. I often find when partners have a visual on how to support a woman i.e. watching me support her, they feel more confident and relaxing having seen some ideas to try themselves. In the studies, not only did partners report higher levels of satisfaction after the birth, but mothers reported feeling more satisfied with their partners role at birth too.
What Will My Ob/Hospital/Midwife Say If I Have a Doula?
More obstetricians and midwives are becoming aware of the doula as they become more popular; most are very supportive or are not bothered by a doula – in fact obstetricians and doulas rarely cross paths. If they do, it’s often for a very short time, during the birth.
In a recent birth I attended, a student midwife told me that they were currently doing a unit on birth support in her studies, and she was very impressed about the benefits and outcomes achieved with women who have doulas.
There is the occasional story I hear about some obstetricians not wanting a woman to have a doula present, however ultimately it is your own choice and decision as to the level of care you receive. An obstetrician is not present for you throughout most of the labour, only if you need intervention or to catch the baby (if they make it!). So continuous support from a known carer is crucial while you labour – because what happens during the labour can affect the outcome. It also is very telling about the sort of care you may receive at the birth if your Obstetrician is not open to you looking for ways to help reduce your chances of interventions. If your doctor is not supportive of you making choices, decisions and avoiding intervention, you may end up feel unsupported and disempowered in labour.
What Training Do Doulas Receive?
In Australia, there are several ways a Doula can train, through courses conducted by very experienced Doulas – some of which are also midwives, doctors and educators. Again, this is not medical training – doulas are trained in professional birth support. As part of a doula’s training, she may be required to read certain materials, attend several births (as an unpaid trainee), write assignments/reports, attend birth education classes and other requirements. If you are interested in becoming a Doula, see our BellyBelly article, Doula Training In Australia. (Doulahanani: In Singapore, you can train as a doula with Foutrimesters or Parentlink)
What Do Couples Think of Doulas?
Check out this short video on YouTube featuring couples talking about doulas:
Here are a few short testimonials from Australian couples who have used professional birth support:
“A very special thank-you… You made such a difference at the birth for us both, encouraging me when it all seemed too hard and helped me achieve the birth that has given our little girl the best start in life. Thanks for sharing this special time with us. I hope our paths cross again. You are a beautiful person with much to give the world.” — Catherine & Jason
“Thank-you for helping us achieve a wonderful birth experience. I felt safe and far more relaxed knowing I had the right support. Everything went exactly as I wished for with minimum intervention and stress¦ I feel sooooo grateful that we had such a great outcome. I am sure it is even helping me get through these difficult first months. I now know I CAN get through anything with determination, knowledge and support! — Meredith & Chris
“Wow I’m still in shock when I think about that long labour and the fantastic result – it was sooo worth it. I truly know that I couldn’t have done it without you – that is a fact. You are amazing and are truly made for the job – I really can’t thank you enough.” — Bronte & Michael – 2006
References and Recommended Reading
1. Klaus M, Kennell J, Berkowitz G, Klaus P. Maternal assistance in support and labor: Father, nurse, midwife, or doula. Clin Cons Obstet and Gyn 1992; 4:211-17.
2. The Doula Advantage, Rachel Gurevich, Prima Publishing 2003
3. The Doula Book, Marshall H. Klaus, M.D., John H. Kennell, M.D., and Phyllis H. Klaus, C.S.W., M.F.T. Da Capo Press, 2002
4. Sosa R, Kennell J, Klaus M, Robertson S, Urrutia J. The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. N Engl J Med 1980; 303(11):597-600.
Kelly Winder is a birth attendant (aka doula), the creator of BellyBelly and mum to two beautiful children. Become a fan of BellyBelly on Facebook or add Kelly as a friend (frequently adding articles and stories). You can also follow BellyBelly on Twitter.
Disclaimer: Doulahanani did not write this article. This article is from bellybelly.com.au